AB0313 UNDERSTANDING DISEASE PREVALENCE AND COMORBIDITY PROFILES AMONG SEROPOSITIVE AND SERONEGATIVE RHEUMATOID ARTHRITIS PATIENTS IN PUERTO RICO
Authors: F. Arenal-Cruz, G. Jobson, E. Villanueva, J. Zhu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Prevalence of rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide antibody (ACPA) positivity in US patients with rheumatoid arthritis (RA) is around 70% <sup>[1]</sup>. Seropositive RA status, defined by positivity for RF and/or ACPA, is associated with poor disease prognosis <sup>[2]</sup>. Little is known about the prevalence of RA, percentages of seropositive RA versus seronegative RA, and the comorbidity profile and infections of these patients in Puerto Rico (PR). <h3>Objectives</h3> To estimate the prevalence of seropositive and seronegative RA in PR and to understand the demographic and clinical characteristics among Puerto Ricans with seropositive versus seronegative RA. <h3>Methods</h3> This was a descriptive retrospective observational cohort study using Merative™ MarketScan® claims database. To examine RA prevalence, eligible Puerto Rican adults were required to have ≥6 months of continuous enrolment (CE) from October 1, 2016, through April 30, 2021 (index period), have ≥3 visits with RA diagnose codes (ICD-10-CM M05 or M06, ignoring M06.1 and M06.4, with ≥2 claims with RA diagnoses occurring between 7 and 365 days of one another). Those patients with ≥1 M05 diagnosis code during the index period were categorized into the seropositive cohort (SP), the index date is the date of the first M05 diagnosis during the index period; otherwise, they were classified into the seronegative cohort (SN), the index date was the date of first an M06 (excluding M06.1 and M06.4), Patients with RA diagnosis in the baseline period were excluded. To assess comorbidity profile and infections, the eligible patients were also required to have ≥12 months CE prior to index date. The demographics, clinical characteristics, and infections were assessed during 12 months prior to the index date (baseline period), and standardized differences were estimated. The crude incidence rate (total new cases/100 person-year) of comorbid conditions and infections were estimated during the follow-up period. <h3>Results</h3> The prevalence of RA among Puerto Ricans was 1.03%. Of 141 patients with RA, 56.7% of them were seropositive. Within eligible seropositive (n=53) and seronegative (n=42) RA patients for the evaluation of comorbidities and infections, the mean (SD) of age were 50.75±12.93 and 49.36±11.22 years (<i>d</i> = 0.11), respectively. Most patients were females (79.25% for SP vs 71.43% for SN, <i>d</i>=0.18) and had commercial insurance (92.45% for SP vs 97.62% for SN, <i>d</i>=0.24). The mean (SD) of Charlson Comorbidity Index scores were 0.79±1.17 vs 0.64±1.01(<i>d</i>=0.14) for seropositive and seronegative respectively. For both seropositive and seronegative cohorts, the most prevalent comorbidities were hyperlipidemia (37.74% vs 30.95%, <i>d</i>=0.14), hypertension (33.96% vs 66.67%, <i>d</i>=0.69) and Type II diabetes (24.53% vs 21.43%, <i>d</i>=0.07) respectively. The most frequent infections were those happening in the urinary tract (18.87% for SP vs 14.29% for SN, <i>d</i>=0.12). In the follow-up period, the crude IR/100-person year were 79.34 and 33.45 for hyperlipidemia; 42.74 and 32.46 for T2DM; 27.47 vs 29.46 for hypertension, and 19.53 vs 25.00 for urinary tract infection for seropositive and seronegative RA cohorts, respectively. <h3>Conclusion</h3> This study found that the prevalence of RA among Puerto Ricans was similar to that reported in US mainland, with most (56.7%) presenting seropositive RA. We also observed a substantial burden of comorbidities among both seropositive and seronegative RA patients. Future studies with a large sample size are warranted. <h3>References</h3> [1] Sokolove J, Johnson DS, Lahey LJ, Wagner CA, Cheng D, Thiele GM, Michaud K, Sayles H, Reimold AM, Caplan L, Cannon GW, Kerr G, Mikuls TR, Robinson WH. Rheumatoid factor as a potentiator of anti-citrullinated protein antibody-mediated inflammation in rheumatoid arthritis. Arthritis Rheumatol. 2014 Apr;66(4):813-21. [2] Finckh A, Choi HK, Wolfe F. Progression of radiographic joint damage in different eras: trends towards milder disease in rheumatoid arthritis are attributable to improved treatment. Ann Rheum Dis 2006; 65:1192–7. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Fernando Arenal-Cruz Shareholder of: Hold stock or stock options at Bristol Myers Squibb, Employee of: During the conduct of the study, I was an employee of Bristol Myers Squibb, Greeta Jobson Consultant of: Bristol Myers Squibb, Eneida Villanueva Shareholder of: Hold stock or stock options at Bristol Myers Squibb, Employee of: During the conduct of the study, I was an employee of Bristol Myers Squibb, Julia Zhu Shareholder of: Hold stock or stock options at Bristol Myers Squibb, Employee of: During the conduct of the study, I was an employee of Bristol Myers Squibb.